case 5 anatomy

Question 1

In which abdominal region is liver situated in?

Answer 1

Right upper quadrant liver occupies most of the right hypochondrium & upper epigastrium and extends into the left hypochondrium

Question 2

Falciform ligament divides the liver into

Answer 2

Right and left lobes

Question 3

Where does the falciform ligament attach to?

Answer 3

From anterior margin of left liver lobe to abdominal peritoneum

Question 4

Where and what is the ligamentum teres or round ligament?

Answer 4

in the free edge of the falciform ligament, it’s the remnant of foetal umbilical vein

Question 5

Where is the subhepatic recess?

Answer 5

Between inferior surface of liver and transverse colon

Question 6

Where is the subphrenic recess?

Answer 6

between the diaphragm and the superior & anterior aspects of the diaphragmatic surface of the liver

Question 7

Which structures lie in the right sagittal fissure?

Answer 7

IVC and gall bladder

Question 8

Which structures lie in the left sagittal fissure?

Answer 8

Ligamentum venosum and round ligament of liver

Question 9

What is ligamentum venosum?

Answer 9

Embryological remnant of ductus venosum connecting umbilical vein to IVC, surpassing the liver

Question 10

Horizontal groove contains the ports hepatis Name the structures enter/exit here?

Answer 10

Hepatic artery, Portal vein, Bile duct

Question 11

Name the 4 lobes of liver

Answer 11

Right, Left, Caudate, Quadrate

Question 12

The peritoneal reflections that surround the bare area form

Answer 12

Coronary ligament

Question 13

Coronary ligament consists of

Answer 13

Anterior and posterior leaves

Question 14

Anterior and posterior leaves of coronary ligament meet in the right and left to form

Answer 14

Right and left triangular ligaments

Question 15

Route taken by bile from liver to gall bladder or to duodenum

Answer 15

Bile leaves the liver via small biliary ducts into the larger right & left hepatic ducts to common hepatic duct to cystic duct form gall bladder joins to form common bile duct to major pancreatic duct to empty bile into the ampulla which then empties into the second part or descending part of the duodenum

Question 16

What percentage of blood supply of liver comes from hepatic artery proper

Answer 16

20-25%

Question 17

Where does hepatic artery proper arise from?

Answer 17

Coeliac trunk

Question 18

Where does hepatic artery bifurcate into right and left hepatic arteries?

Answer 18

At the porta hepatis

Question 19

What percentage of blood supply of liver comes from hepatic Portal vein

Answer 19

75-80%

Question 20

Which vessels join to form hepatic portal vein

Answer 20

Superior mesenteric vein and splenic vein join posterior to neck of pancreas

Question 21

Where does inferior mesenteric vein drain into?

Answer 21

Splenic vein

Question 22

Where do hepatic veins drain into?

Answer 22

into the inferior vena cava just inferior to the diaphragm.

Question 23

Lymphatic drainage of liver

Answer 23

hepatic lymph nodes to Celiac lymph nodes to Cisterna chyli to Thoracic duct

Question 24

Sympathetic innervation and action on liver

Answer 24

Hepatic plexus from celiac plexus and cause glycogenolysis, gluconeogenesis, VLDL secretion, and ketogenesis

Question 25

ParaSympathetic innervation and action on liver

Answer 25

Vagus nerve - gluconeogenesis

Question 26

Pain transmission in right upper quadrant

Answer 26

Sensory innervation is probably transmitted via vagal & spinal afferent nerves, causing right upper quadrant pain

Question 27

Name the connective tissue capsule surrounding the liver

Answer 27

Glissons capsule

Question 28

What are kupffer cells?

Answer 28

specialised macrophages located in the liver lining the walls of the sinusoids that form part of the reticuloendothelial system. They help to break down red blood cells

Question 29

How does the wall of the gall bladder differ from the rest of GIT

Answer 29

Doesn’t have muscularis mucosae

Question 30

Which important vessels rise from right hepatic artery?

Answer 30

Cystic artery?

Question 31

What stimulates gall bladder to contract and release bile?

Answer 31

Presence of fatty chyme in duodenum leads to release of hormone CCK. CCK stimulates gall bladder contraction.

Question 32

What controls the entry of bile into duodenum?

Answer 32

Controlled by hepatoduodenal sphincter that is relaxed by the hormone CCK